BackgroundCombination of antipsychotic drugs and modified electroconvulsive therapy （MECT） is currently a commonly used method for treating schizophrenia， but its efficacy varies among different patient groups. ObjectiveTo explore the therapeutic effects of MECT on schizophrenia patients living in different urban versus rural environments， so as to provide references for the selection of treatment plans based on patients' residence. MethodsA total of 587 patients hospitalized at Luzhou Mental Health Center， Zigong Mental Health Center and Yibin Fourth People's Hospital from May 2018 to August 2022， who met the diagnostic criteria for schizophrenia in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） ，were included in the study. Patients were divided into two groups： medication-only group （n=106） and MECT combined with medication group （n=481）. In MECT combined with medication group， 24 rural patients residing in urban areas were excluded， leaving the remaining patients divided into urban group （n=103） and rural group （n=354） based on their place of residence. Positive and Negative Syndrome Scale （PANSS） was used to assess the severity of symptoms. Clinical efficacy was evaluated using PANSS score reduction rate， and covariance analysis was used to compare the therapeutic effects of different patients. ResultsThe differences of reduction rate of PANSS total score， positive symptom scale score and negative symptom scale score as well as treatment effectiveness rate between MECT combined with medication group and medication-only group were statistically significant （F=11.149， 12.111， 31.725， χ²=14.010， P<0.01）. Statistically significant differences were also observed in reduction rate of PANSS total score and positive symptom subscale score as well as treatment effectiveness rate between urban and rural patients in MECT combined with medication group （F=3.946， 4.523， χ²=4.033， P<0.05）. ConclusionThe efficacy of MECT combined with medication may be superior to medication alone in the treatment of schizophrenia， and the combined therapy may be more effective in urban patients than that in rural patients， with potentially more pronounced improvements in positive symptoms.

Objective:To investigate the relationship between 1p/16q loss of heterozygosity (LOH) and 1p gain in Wilms tumor and their clinicopathologic characteristics and prognosis.Methods:A total of 175 Wilms tumor samples received from the Department of Pathology, Beijing Children′s Hospital from September 2019 to August 2022 were retrospectively analyzed. The histopathologic type and presence of lymph node involvement were evaluated by two pathologists. The clinical data including patients′gender, age, tumor location, preoperative chemotherapy, and tumor stage were summarized. Fluorescence in situ hybridization (FISH) was done to detect 1p/16q LOH and 1p gain and their correlation with the clinicopathological features and prognosis were analyzed.Results:Among the 175 samples, 86 cases (49.1%) were male and 89 (50.9%) were female. The mean age was (3.5±2.9) years, and the median age was 2.6 years. There were 26 (14.9%) cases with 1p LOH, 28 (16.0%) cases with 16q LOH, 10 (5.7%) cases of LOH at both 1p and 16q, and 53 (30.3%) cases with 1q gain. 1q gain was significantly associated with 1p LOH ( P<0.01) and 16q LOH ( P<0.01). There were significant differences ( P<0.01) between 1q gain, 1p LOH and 16q LOH among different age groups. The rate of 16q LOH in the high-risk histopathological subtype (50.0%) was significantly higher than that in the intermediate-risk subtype (13.6%, P<0.05). The frequency of 1q gain, 1p LOH, and 16q LOH in children with advanced clinical stages (Ⅲ and Ⅳ) was significantly higher than that in children with early clinical stages (Ⅰ and Ⅱ). 1q gain, 1p LOH, and 16q LOH showed no significant correlation with gender, unilateral or bilateral disease, chemotherapy, or lymph node metastasis. The progression-free survival (PFS) time for patients with 1q gain and 1p LOH was significantly shorter than those without these aberrations ( P<0.05). Additionally, the PFS time of patients with 16q LOH was slightly shorter than those with normal 16q, although the difference was not statistically significant. Patients with stage Ⅲ to Ⅳ disease exhibiting 1q gain or 1p LOH had a significantly higher relative risk of recurrence, metastasis, and mortality. Conclusions:1p/16q LOH and 1q gain are associated with age, high-risk histological type, and clinical stage in Wilms tumor. 1q gain and 1p LOH are significantly correlated with the prognosis of Wilms tumor.

Objective:To analyze the implementation effect of single disease payment policy for day surgery (hereinafter referred to as the policy), for references for the reform of medical insurance payment.Methods:By collecting the information of inpatients from 2017 to 2019 in a tertiary hospital, the research group took patients with colorectal benign tumor and nodular goitre as the policy implementation group and the control group respectively. 2017-2018 was the pre implementation stage of the policy, and 2019 was the post implementation stage of the policy. The difference-in-differences (DID) model was used to analyze the changes in indicators such as length of stay and hospitalization expenses after policy implementation, under whether the policy is implemented or not, as well as before or after policy implementation.Results:A total of 2 419 patients were included, including 927 patients with nodular goiter in the control group and 1 492 patients with colorectal benign tumors in the policy implementation group (688 patients before the policy implementation and 804 patients after the policy implementation). The results of DID showed that the hospital days for patients with colorectal benign tumor decreased by 56.53%, the hospitalization expenses decreased by 26.51%, the out-of-pocket expenses decreased by 26.66%, the treatment expenses increased by 11.96%, the drug expenses decreased by 50.29% and the consumables expenses decreased by 20.23% after the implementation of the policy.Conclusions:The implementation of the policy could reduce length of stay, hospitalization expenses and out-of-pocket expenses, optimize the structure of hospitalization expenses, improve the efficiency of hospital diagnosis and treatment, and help the hospital realize its transformation from a size expansion to a quality and benefit expansion.

Objective:To discuss the treatment methods for old pelvic fractures and urethral injuries in young girls.Methods:We retrospectively analyzed the clinical data of 10 girls, mean age of(8.5±4.3)years with old pelvic fractures and urethral injuries treated with different surgical methods in our hospital from April 2015 to April 2023. 7 cases were complicated with urethrovaginal fistula, 1 case was complicated with vesicovaginal fistula; 5 patients had distal urethral atresia or stenosis; 5 cases complicated with vaginal stenosis or partial atresia. One case underwent repair of urethrovaginal fistula via transpertoineal approach, two cases underwent urethral anastomosis (end to end anastomosis) via transpubic approach, one case underwent repair of urethrovaginal fistula and bladder neck urethral anastomosis via transpubic approach, four cases underwent urethroplasty repair of urethrovaginal fistula and bladder neck reconstruction surgery, one underwent urethroplasty and bladder neck reconstruction surgery via transpubic approach, one underwent augmented enterocystoplasty and continent urinary diversion by using the appendix. Observe the urination condition after operation (Urinary incontinence is defined as the use of more than 1 piece of urine pad per day, good urination is defined as the use of ≤ 1 piece of urine pad per day, and dysuria is defined as the complaint of laborious urination, and the maximum urine flow rate is less than 10 ml/s).Results:All surgeries were successfully completed without complications such as wound infection or tissue necrosis.The postoperative follow-up time was (52.0±26.2) months. 2 cases achieved good continence and no dysuria.Postoperative complications occurred in 7 cases, of which 2 cases had dysuria due to urethral stricture and improved after urethral dilatation; 5 cases of urethrovaginal fistula recurred, of which 3 cases had undergone rerepair surgery, and 2 of them achieved good urinary control without dysuria. One case with enterocystoplasty and contiunent urinary diversion recovered well after surgery.Conclusions:The management of old pelvic fractures and urethral injuries in girls is complicated, with a high rate of postoperative complications. It is necessary to choose appropriate treatment methods based on age, severity of the lesion, and urethral and vaginal conditions.

Objective:To investigate and understand current status of radiotherapy resources in the Association of Southeast Asian Nations (ASEAN) and analyze the radiotherapy needs of ASEAN countries, aiming to provide suggestions for China's radiotherapy technology international assistance work.Methods:We created a database of 10 ASEAN countries using open-source data, including data on population size, per capita gross national income, new cancer cases, and radiotherapy equipment (megavolt units). We also estimated the number of cases requiring radiotherapy and the demand for radiotherapy equipment. Descriptive statistics were used to present aggregate data and national data.Results:In 2020, the number of new cancer cases in ASEAN countries was 1.0992 million, and the estimated total number of cancer patients requiring radiotherapy was 700 300. The number of radiotherapy equipment required was 1 406. At present, the actual number of radiotherapy equipment in ASEAN countries is 564, and there is a certain gap between the existing radiotherapy resources in some ASEAN countries and the actual needs of cancer patients in their own countries. In 2040, the estimated number of new cancer cases in ASEAN countries will be 1.803 million, and the estimated total number of cancer patients who need radiotherapy in ASEAN countries will be 1.141 2 million. The number of required radiotherapy equipment will be 2 287. By 2040, the growth rate of radiation therapy equipment demand in ASEAN countries will be 305%, and all ASEAN countries need to allocate more radiotherapy resources to cope with the increase in the number of cancer patients and radiotherapy demand.Conclusions:ASEAN countries have a huge demand for radiotherapy in the next two decades, while there are significant differences among different countries. China's precision radiotherapy science and technology have huge potential for ASEAN countries. Radiotherapy science and technology international assistance work based on the needs of ASEAN countries will help China's radiotherapy continue to exert influence and promote the health and well-being of people in ASEAN countries.

Objective:To observe the expression of microRNA (miRNA)-7159-5p in gastric cancer tissues, and explore its effect on the proliferation and invasion of gastric cancer cells and its molecular mechanism.Methods:The cancer tissues and adjacent tissues of 29 patients with gastric cancer who underwent surgical resection in Hubei 672 Orthopedic Hospital of Integrated Traditional Chinese and Western Medicine from March 2018 to November 2019 were collected. Fluorescence real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of miR-7159-5p in gastric cancer tissues and adjacent tissues, gastric cancer cell lines and normal gastric epithelial cell lines. Select the cell line with the lowest expression of miR-7159-5p, set the control group and the experimental group, and be transfected with control and miR-7159-5p mimics respectively. qRT-PCR was used to detect the expression of miR-7159-5p in transfected cells. The lymphocyte proliferation test (MTS method) was used to detect the proliferation of transfected cells, and the Transwell chamber method was used to detect the invasion activity of transfected cells. The miRNAMap database and dual luciferase reporter gene experiment were used to predict and verify the target genes of miR-7159-5p. qRT-PCR and Western blot were used to detect the expression of target genes in transfected cells.Results:The expression of miR-7159-5p in gastric cancer tissues was lower than that in adjacent tissues ( P<0.01), the expression of miR-7159-5p in gastric cancer cell lines was lower than that of normal gastric epithelial cells (all P<0.01), and the expression of miR-7159-5p was the lowest in SGC7901 cells ( P<0.01). After transfection, the expression of miR-7159-5p in SGC7901 cells of the experimental group was significantly higher than that in the control group ( P<0.01). After transfection, the proliferation activity and the cell invasion activity of the experimental group was significantly lower than that of the control group (all P<0.01). The target gene of miR-7159-5p was tripartite motif 26 (TRIM26). After transfection, the expression of TRIM26 mRNA in SGC7901 cells of the experimental group was significantly lower than that in the control group ( P<0.01). Western blot showed that after transfection, the expression of TRIM26, c-Myc, cyclin D1, β-catenin protein were lower than those in the control group (all P<0.05). Conclusions:The expression of miR-7159-5p is low in gastric cancer tissues, and miR-7159-5p can inhibit the proliferation and invasion of SGC7901 cells by down-regulating the expression of TRIM26.

Objective:To discuss the diagnosis and treatment 0f WAGR syndrome.Methods:The clinical data of 10 cases of WAGR syndrome children admitted to our hospital from January 2008 to November 2019 were respectively analyzed including the clinical features, diagnosis, and surgical treatments. There were 6 males and 4 females, aged from 13 to 36 months, with an average of 23.6 months. 9 cases were diagnosed as iris absence due to ocular abnormalities in infancy, and 1 case was diagnosed as iris absence due to ocular abnormalities by physical examination because of renal mass. There were 2 boys with cryptorchidism, and 2 boys with hypospadias, 1 of which did not received operation because of mild hypospadias, and another undergoing surgery. There were no abnormality of genitourinary system in the remaining 5 cases. There were 7 cases of unilateral nephroblastoma, with 1 case at the left and 6 cases at the right, and there were 3 cases of bilateral nephroblastoma. Abdominal doppler ultrasound and enhanced abdominal CT were performed for all patients. Abdominal doppler ultrasound indicated solid mass in renal parenchyma or non-uniform echo zone. Abdominal enhanced CT indicated renal tumor with diameter of 1.8 cm-12.7 cm and locally non-uniform enhanced echo. Among the 7 cases of unilateral nephroblastoma, 4 underwent nephrectomy, 1 underwent tumor enucleation, and 2 underwent tumor enucleation for unilateral tumor complicated with nephrogenic rests. There were 3 cases of bilateral nephroblastoma, 2 cases undergoing unilateral tumor enucleation firstly and contralateral tumor enucleation following chemotherapy. One case underwent unilateral tumor nephrectomy followed by contralateral tumor enucleation. One case of unilateral nephrogenic rests did not undergo renal tumor surgery. Preoperative chemotherapy was performed in 7 patients, including 3 bilateral nephroblastoma, 1 unilateral nephroblastoma combined with contralateral nephroblastoma, and 3 unilateral tumors larger enough to pass the midline. The chemotherapy regimen was VCR+ ACTD in 5 cases, VCR+ ACTD+ CTX+ DOX/CDDP+ VP16 and VCR+ CTX+ DOX in another 2 cases respectively.Results:All 10 cases were diagnosed as nephroblastoma. There were 3 patients without preoperative chemotherapy which belongs to COG stageⅠ(1 case) and STAGEⅢ(2 cases); Preoperative chemotherapy was performed in 2 patients with SIOP stage Ⅱ, 2 patients with SIOP stage Ⅲ, and 3 patients with SIOP stageⅤ. Nine children received regular chemotherapy after surgery, among which 1 child in stage Ⅰ received DD4A chemotherapy regimens, 2 children in stage Ⅱ received DD4A and EE4A regimen respectively, and 3 of the 4 children in stage Ⅲ received regular chemotherapy after surgery, including EE4A(1 case)and DD4A(2 cases). EE4A(1 case)and DD4A(2 cases) chemotherapy were performed in 3 patients with stage Ⅴ according to their unilateral tumor stage. Ten cases were followed up, with 9 of the 10 cases having no tumor recurrence or metastasis, and death in 1 case. At present, abdominal doppler ultrasound of 1 child with nephrogenic rests showed no obvious progress. The renal function of 9 children was not significantly abnormal during the regular follow-up. The results of intelligence screening showed that 6 of the 10 patients were significantly behind their peers, and 4 had no obvious abnormality compared with their peers. Gene tests were performed 3 times after surgery, and the results showed the deletion of 11p13 and adjacent distal genes.Conclusions:WAGR syndrome is rare in clinical practice, and renal ultrasound should be monitored after diagnosis to detect renal tumors in early stage. For bilateral cases, renal function should be preserved as long as possible in order to reduce the probability of renal failure. Long-term follow-up of nephroblastoma with this syndrome is particularly important.

The cultivation and production of cucumber are seriously affected by downy mildew caused by Pseudoperonospora cubensis. Downy mildew damages leaves, stems and inflorescences, and then reduces the yield and quality of cucumber. This review summarized the research advances in cucumber downy mildew, including pathogen detection and defense pathways, regulatory factors, mining of pathogens-resistant candidate genes, proteomic and genomic analysis, and development of QTL remarks. This review may facilitate clarifying the resistance mechanisms of cucumber to downy mildew.
Cucumis sativus/genetics* ; Oomycetes/genetics* ; Peronospora ; Plant Diseases/genetics* ; Proteomics

OBJECTIVE To study the effects of cy cloastragenol （CAG） on carbon tetrachloride （CCl4）-induced hepatic fibrosis（HF）and glycolysis in mice. METHODS Male ICR mice were randomly divided into blank group ，model group ，CAG low-dose，medium-dose and high-dose groups （60，120，240 mg/kg），with 6 mice in each group. Except that blank group was given olive oil intraperitoneally ，the mice in other groups were intraperitoneally injected with 10％CCl4-olive oil solution （5 mL/kg） three times a week for 8 weeks to induce HF model. From the 4th week after modeling ，mice in each drug group were given corresponding drug solution intragastrically （10 mL/kg），and mice in blank group and model group were given 0.5％ sodium carboxymethyl cellulose solution intragastrically （10 mL/kg），once a day for 4 weeks. During the experiment ，the body weight of mice were weighted ；after last gastrogavage ，the liver weight was weighted and liver indexes of mice were calculated. The changes of hepatic injury indexes [aspartate aminotransferase （AST）， alanine aminotransferase （ALT）]， related indexes of HF [hematoxylin-eosin （HE）staining score ，Masson and Picrosirius red staining collagen volume fraction ，collagen Ⅰ，α-smooth muscle actin （α-SMA）] and related indexes of glycolysis [lactic acid （LD），hexokinase（HK），phosphofructokinase（PFK）， pyruvate kinase （PK）] were all detected. RESULTS Compared with model group ，the collagen deposition and fibrosis of mice in each drug group were reduced ，and the body weights of mice （except for CAG low-dose group ）were increased to some extent （P＜0.05）. Liver indexes ，serum levels of ALT and AST ，HE staining score of liver histopathology ，Masson and Picrosirius red staining collagen volume fraction ，protein expression of collagen Ⅰ and α-SMA，serum content of LD ，the levels of HK ，PFK and PK in serum and hepatic tissues （except for hepatic tissue of CAG low-dose group ）were all decreased significantly （P＜0.05）. CONCLUSIONS CAG can improve HF in mice induced by CCl 4，and reduce the levels of key enzymes and products of glycolysis.

The vagina contains at least a billion microbial cells,dominated by lactobacilli.Here we perform metagenomic shotgun sequencing on cervical and fecal samples from a cohort of 516 Chinese women of reproductive age,as well as cervical,fecal,and salivary samples from a second cohort of 632 women.Factors such as pregnancy history,delivery history,cesarean section,and breastfeeding were all more important than menstrual cycle in shaping the microbiome,and such information would be necessary before trying to interpret differences between vagino-cervical micro-biome data.Greater proportion of Bifidobacterium breve was seen with older age at sexual debut.The relative abundance of lactobacilli especially Lactobacillus crispatus was negatively associated with pregnancy history.Potential markers for lack of menstrual regularity,heavy flow,dysmenor-rhea,and contraceptives were also identified.Lactobacilli were rare during breastfeeding or post-menopause.Other features such as mood fluctuations and facial speckles could potentially be predicted from the vagino-cervical microbiome.Gut and salivary microbiomes,plasma vitamins,metals,amino acids,and hormones showed associations with the vagino-cervical microbiome.Our results offer an unprecedented glimpse into the microbiota of the female reproductive tract and call for international collaborations to better understand its long-term health impact other than in the settings of infection or pre-term birth.